<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565801258
Report Date: 03/12/2026
Date Signed: 03/12/2026 04:02:49 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/06/2026 and conducted by Evaluator Emily Peraldi
COMPLAINT CONTROL NUMBER: 29-AS-20260306103501
FACILITY NAME:MG FAMILY HOMEFACILITY NUMBER:
565801258
ADMINISTRATOR:JOSE ONGFACILITY TYPE:
735
ADDRESS:814 DOLLIE STREETTELEPHONE:
(805) 986-8908
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY:6CENSUS: 5DATE:
03/12/2026
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Maria MirandaTIME COMPLETED:
04:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is not kept clean, safe, sanitary or free from odors
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Emily Peraldi along with Quality Assurance Specialist (QAS) Tri-Counties Regional Center Patrick Brown conducted an unannounced initial complaint visit to this facility. At 10:30 a.m., the LPA and QAS met with staff and explained the reason for the visit. At 10:40 a.m., Administrator Jose Ong arrived at the facility. At 11:40 a.m., Administrator, Maria Miranda arrived at the facility.

Starting 10:31 a.m., the LPA and QAS along with staff conducted a physical plant tour. Between 10:33 a.m. and 3:12 p.m., the LPA conducted interviews with both Administrators, six (6) staff and four (4) clients. At 11:32 a.m., the LPA conducted a file review for Client #1 (C1). At 12:00 p.m., the LPA conducted an interview with C1’s service coordinator. Continued on LIC 9099-C.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
Control Number 29-AS-20260306103501
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: MG FAMILY HOME
FACILITY NUMBER: 565801258
VISIT DATE: 03/12/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Regarding the allegations: Facility is not kept clean, safe, sanitary or free from odors. It was alleged that the facility had a foul odor and was not kept clean. During today’s visit, the LPA and QAS conducted a physical plant tour and observed client rooms’ walls uncleaned and with visible dust. The LPA and QAS also observed client restrooms with visible dust on the light bulbs and above the shower. The LPA and QAS spoke with the Administrator, Jose Ong regarding deep cleaning the client rooms and restrooms, especially the walls and windows. Jose Ong explained that the client rooms are being painted today and the rest of the week and that the walls will be cleaned and dusted prior to painting. Throughout the visit, the LPA did not smell any foul odors. However, the LPA did observe areas of the facility in need of deep cleaning such as client rooms, walls and restrooms. Based on observations the preponderance of evidence standard has been met, therefore the above allegation is deemed Substantiated.

Pursuant to Title 22, CA Code of Regulations, the following deficiency was cited (refer to LIC 9099-D).

Exit interview conducted. A copy of the report and appeal rights were provided.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 29-AS-20260306103501
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: MG FAMILY HOME
FACILITY NUMBER: 565801258
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/12/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/27/2026
Section Cited
CCR
80087(a)
1
2
3
4
5
6
7
80087 (a) Buildings and Grounds (a)The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. This requirement is not met as evidenced by:
1
2
3
4
5
6
7
The Administrator explained that the facility is in the process of getting painted and new baseboards. The Administrators stated that the facility will be deep cleaned and will send proof to the LPA.
8
9
10
11
12
13
14
Based on observation, the licensee failed to comply with the section cited above the LPA observed client rooms’ walls uncleaned and with visible dust which poses a potential health and personal rights risk to persons in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/06/2026 and conducted by Evaluator Emily Peraldi
COMPLAINT CONTROL NUMBER: 29-AS-20260306103501

FACILITY NAME:MG FAMILY HOMEFACILITY NUMBER:
565801258
ADMINISTRATOR:JOSE ONGFACILITY TYPE:
735
ADDRESS:814 DOLLIE STREETTELEPHONE:
(805) 986-8908
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY:6CENSUS: 5DATE:
03/12/2026
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Maria MirandaTIME COMPLETED:
04:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not ensure resident's hygiene needs were met.
Staff did not notify authorized representative of incident.
Staff did not treat resident with dignity and respect.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Emily Peraldi along with Quality Assurance Specialist (QAS) Tri-Counties Regional Center Patrick Brown conducted an unannounced initial complaint visit to this facility. At 10:30 a.m., the LPA and QAS met with staff and explained the reason for the visit. At 10:40 a.m., Administrator Jose Ong arrived at the facility. At 11:40 a.m., Administrator, Maria Miranda arrived at the facility.

Starting 10:31 a.m., the LPA and QAS along with staff conducted a physical plant tour. Between 10:33 a.m. and 3:12 p.m., the LPA conducted interview with both Administrators, six (6) staff and four (4) clients. At 11:32 a.m., the LPA conducted a file review for Client #1 (C1). At 12:00 p.m., the LPA conducted an interview with C1’s service coordinator. Continued on LIC 9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 29-AS-20260306103501
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: MG FAMILY HOME
FACILITY NUMBER: 565801258
VISIT DATE: 03/12/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Regarding the allegations: 1.) Staff did not ensure resident's hygiene needs were met. It was alleged that staff would not assist Client #1 (C1) with bathing. Interviews with staff and Administrators revealed that C1 needed full assistance and supervision with bathing. Staff interviews stated that they would assist C1 to take showers daily, however staff do not force clients, including C1 to shower and that clients have the right to refuse showering. Interviews with clients did not reveal any concerns regarding staff. Interview with C1’s service coordinator did not reveal concerns regarding C1’s hygiene. The information obtained during the investigation did not include evidence sufficient to corroborate the allegation. Although the allegation may have happened or is valid, there is not sufficient evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed Unsubstantiated at this time.

2.) Staff did not notify authorized representative of incident. It was alleged that on 02/09/2026 C1 was sent to urgent care and C1’s authorized representative was not notified by staff. Administrator Maria Miranda explained that she is the Administrator that communicates with C1’s authorized representative. Maria said that she would communicate with C1's authorized representative through text messages or phone calls. Maria stated that staff called R1's authorized representative regarding the urgent care visit since she was out of town but that there was no answer. The LPA reminded the Administrator that staff should be leaving voicemails if authorized representatives do not answer. The information obtained during the investigation did not include evidence sufficient to corroborate the allegation. Although the allegation may have happened or is valid, there is not sufficient evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed Unsubstantiated at this time.

3.) Staff did not treat resident with dignity and respect. It was alleged that staff would make fun of C1. Interviews with staff and Administrators denied the allegation. The Administrator Jose Ong stated that C1 at times would be rude to staff but that staff would not be rude to C1. Interview with C1’s service coordinator revealed that C1 has had past behaviors of being rude to staff. Interviews with clients did not reveal any concerns regarding staff. The information obtained during the investigation did not include evidence sufficient to corroborate the allegation. Although the allegation may have happened or is valid, there is not sufficient evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed Unsubstantiated at this time.

Exit interview conducted. A copy of the report was provided.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5